RECOMMENDATION(S)

That the Finance + Facilities Committee makes recommendation to the Board of Health to receive the 2019 Second Quarter Financials, as presented, for information.

BACKGROUND

Wellington-Dufferin-Guelph Public Health’s (WDGPH) annual budget consists of several sub-budgets that are based on the way funding is provided to the Agency. These sub-budgets have been numbered in the report that follows, and the numbering sequence is used consistently throughout.

WDGPH’s main budget consists of the sub-budgets numbered (1) through (7) below. In addition to the main budget, WDGPH receives several community grants for projects which are aligned with, and build upon the work of WDGPH in the community. These community grants are numbered (8) through (14) below.

WDGPH’s cost-shared budgets (1 & 2) comprise approximately 80% of the overall budget. This funding is provided on a 60-40 split basis between the Ministry of Health and Long-Term Care (MOHLTC) and the three Municipalities that WDGPH exists to serve. Appendix 1 provides details of the financial activities that relate to these budgets for Board of Health (BOH) review. As previously discussed with the BOH, WDGPH is taking steps to reduce its liabilities in advance of the amalgamation set to occur in April 2020.

Cost-Shared Sub-budgets

No

Program/Budget Name

Funder(s)

Year-end

1

Cost-shared Mandatory Programs

Ministry of Health and Long - Term Care (MOHLTC); City of Guelph; County of Wellington; County of Dufferin

December 31

2

Cost-shared Related Programs

MOHLTC; City of Guelph; County of Wellington; County of Dufferin

December 31

100% Funded Sub-budgets

No

Program/Budget Name

Funder(s)

Year-end

3

100% MOHLTC Funded Programs

MOHLTC

December 31

4

Healthy Babies Healthy Children

Ministry of Children and Youth Services (MCYS)

December 31

5

Preschool Speech and Language

MCYS

March 31

6

Inclusion Support Services

County of Wellington

December 31

7

Canadian Prenatal Nutrition Program (CPNP)

Public Health Agency of Canada (PHAC)

March 31

External Projects

No

Program/Budget Name

Funder(s)

Year-end

8

Poverty Elimination Task Force (PETF)

City of Guelph, County of Wellington, United Way Wellington-Dufferin-Guelph

December 31

9

Children’s Report Card

County of Wellington

December 31

10

Evidence Informed Planning Project

Dufferin Coalition for Kids

March 31, 2019

11

Preventing Cannabis Harms Through A Youth Driven Campaign

Gambling Research Exchange Ontario

March 28, 2019

12

Mental Health and Addictive Disorders Prevention Program for Grade 7 Students

Gambling Research Exchange Ontario

March 29, 2019

13

ElderTALK

Gambling Research Exchange Ontario

December 31, 2019

14

Climate Change

Health Canada

March 31, 2019

One-Time Grants

No

Program/Budget Name

Funder(s)

Year-end

15

One-Time Grants

MOHLTC

March 31

The 2019 budget, which was approved by the BOH on March 6, 2019 included sub-budgets (1), (2), and (3) above. These sub-budgets, along with the One-Time Grant requests (15) were submitted to the MOHLTC via the Annual Service Plan and Budget Submission on March 6, 2019.

The provincial funding approval from the MOHLTC has not yet been received.

PUBLICHEALTHAND/ORFINANCIALIMPLICATIONS:

Appendix 1: Cost-shared Mandatory Programs (1)

Cost-shared Mandatory Programs are the public health programs and services that are funded by the MOHLTC and the three obligated municipalities under Regulation 553 of the Health Protection and Promotion Act (HPPA): the County of Wellington, the County of Dufferin, and the City of Guelph. Boards of health are responsible for allocating this funding to meet the requirements of the HPPA, the Ontario Public Health Standards (OPHS) and Protocols, and the Accountability Framework, according to local needs and priorities.

Current Net Position:

Appendix “1”represents the statement of revenue and expenditures for the six months ended June 30, 2019 for the Cost-Shared Mandatory programs.

As reported on the attached Statement of Revenue and Expenditures at Appendix “1”, there was a positive variance of $215,845 representing 2.0% of the budgeted spending for the first six months.

Budget to actual variances of greater than $100,000 are explained below:

Salary and benefitsexpenses were $318,933 less than budgeted due to vacant positions and leaves of absence (medical and parental leaves). Funds from leaves and vacant positions are commonly referred to as “gapping dollars.” As previously identified, there is a planned conservative approach to staffing in 2019 to manage the significant uncertainty around Public Health amalgamations that is anticipated to impact gapping dollars within the 2019 budget year. Despite this, there is an internal process for managing variances within the organization and a year-end surplus is not projected in salaries and benefits.

Professional and purchased servicesexpenses were $139,165 less than budgeted for period. Major contributors to this va riance are lower than budgeted legal fees, clinic physician costs, and program advertising.

Building Occupancyexpenses were $203,565 over budget for the period, mainly due to the expensing of Orangeville office renovations of approximately $275,000 to date. This expense was originally slated to be funded solely using Building Reserves but is currently reported as an operating expense as directed by the BOH.

Information and IT equipmentexpenses were $172,349 over budget for the period, mainly due to the expenditure of approximately $250,000 for the procurement of Enterprise Resource Planning software (Sparkrock), which originally was slated to be funded solely using IT Reserves but is currently reported as an operating expense as directed by the BOH.

Appendix “2”: All Other Programs (2 – 14)

Appendix “2”presents the funding received and expenditures made for the period for all other ongoing programs/initiatives at WDGPH For these programs funding is recorded as it is received (on a cash basis) throughout the year. Accruals and deferrals are made as required only at year-end. The timing of receipt of funding may not correspond to the planned expenditures for that funding (for example, in the case of the Vector-Borne Diseases program, funding is flowed evenly throughout the year, but a large portion of that funding is spent over the summer months for mosquito larvaciding).

Funds received for all programs/initiatives are expected to be fully spent in 2019. A description of each of the programs on Appendix “2” follows:

MOHLTC Cost-shared Related Programs

Vector Borne Diseases – funding provided for this program must be used for the ongoing surveillance, public education, prevention and control of all reportable and communicable vector-borne diseases and outbreaks of vector-borne disease, which include, but are not limited to, West Nile Virus and Lyme Disease. 1

Small Drinking Water Systems – this funding is provided to support the ongoing assessments and monitoring of small drinking water systems. Under this program, public health inspectors are required to conduct new and ongoing site-specific risk assessments of all small drinking water systems within the oversight of the BOH; ensure system compliance with the regulation governing the small drinking water systems; and ensure the provision of education and outreach to the owners/operators of small drinking water systems. 1

MOHLTC 100% Funded Related Programs

Needle Exchange– This funding is provided for the purchase of needles and syringes, and their associated disposal costs, for the BOH’s Needle Exchange Program.1

Enhanced Food Safety – This initiative was established to augment the BOH’s capacity to deliver the Food Safety Program. 1

Healthy Smiles Ontario– This program provides prevention and basic treatment services for children and youth from low-income families who are 17 years of age or under and who do not have access to any form of dental coverage. 1

Infectious Diseases Control Initiative–This funding is provided for the sole purpose of monitoring and controlling infectious diseases and enhancing the BOH’s ability to handle and coordinate increased activities related to outbreak management. 1

Smoke Free Ontario – This funding is provided in support of the government’s Healthy Change Strategy and Action Plan. The Smoke-Free Ontario Strategy is a multi-level comprehensive tobacco control strategy aiming to eliminate tobacco-related illness and death by preventing experimentation and escalation of tobacco use among children, youth and young adults; increasing and supporting cessation by motivating and assisting people to quit tobacco use; and protecting the health of Ontarians by eliminating involuntary exposure to second-hand smoke. 1

Electronic Cigarettes Act – This funding was provided for the implementation and enforcement of the Electronic Cigarettes Act (ECA) .

Harm Reduction Program Enhancement – This funding is provided to help the BOH address local Opioid use through three main areas:

Local Opioid Response;

Naloxone Distribution and Training; and

Opioid Overdose Early Warning and Surveillance.

Enhanced Safe Water – The purpose of this initiative is to increase the BOH’s capacity to meet the requirements of the Safe Water Program Standard under the OPHS. 1

Chief Nursing Officer – Funding is provided for the Chief Nursing Officer position atWDGPH. The purpose of the Chief Nursing Officer position in each BOH is to enhance the health outcomes of the community at individual, group and population levels, through contributions to organizational strategic planning and decision making; by facilitating recruitment and retention of qualified, competen t public health nursing staff and by enabling quality public health nursing practice. 1

Infection Prevention and Control Nurse – This funding is provided to contribute to the cost of a Public Health Nurse, and the majority of the nurse’s time must be spent on infection prevention and control activities. 1

Social Determinants of Health Nurses Initiative– With this funding, public health nurses with specific knowledge and expertise on social determinants of health and health inequities issues will provide enhanced supports internally and externally to the BOH to address the needs of priority populations impacted most negatively by the social determinants of health in the BOH area.1

MOH Compensation Initiative – Funding is provided by the Province to subsidize the salary/benefits/stipends for the Medical Officer of Health to ensure compensation falls within the salary ranges outlined in the 2012 Physician Services Agreement and subsequent addendums to that agreement .1

MCCSS Funded Programs

Healthy Babies Healthy Children– The MCCSS provides funding for this program with the goal of helping children get a healthy start in life. The program does this by helping infants and children up to age six and their families through screening and assessments, supports for new parents and help in finding community programs and resources. 2

Preschool Speech and Language – As the lead agency for the Wellington-Dufferin-Guelph area Preschool Speech and Language Program, WDGPH coordinates the provision of speech pathology services delivered by Groves Memorial Community Hospital, North Wellington Health Care Corporation and St. Joseph’s Health Centre. This funding has a fiscal year of April to March.

County of Wellington Weetalk- This fun ding is provided by the County of Wellington for a program called Weetalk. Weetalk funds Speech Language Pathologists (SLPs) in licensed childcares to provide support to staff to integrate children with language challenges fully into their programs.

Canadian Prenatal Nutrition Program- This funding is provided by the PHAC, on an April to March fiscal year, to deliver a comprehensive program to promote and support optimal nutrition and health in pregnant and early postpartum women who live in difficult life situations .3

Other Community Grants - Various other community grants are provided by the municipalities served by WDGPH and other community partners including: United Way Wellington-Dufferin-Guelph, Dufferin Coalition for Kids, and Gambling Research Exchange Ontario. The work undertaken with this funding aligns with the mandate of WDGPH under the OPHS.

Appendix “3” – One-time Grants

Appendix “3” presents the one-time grants approved as part of the 2018 Provincial Funding Approval which were deferred to the first quarter of 2019 in accordance with the funding approval provided by the MOHLTC, as well as the approved 2018 one-time grants. The 2018 one-time grants were approved for use between April 1, 2018 and March 31, 2019. Funds remaining from the one -time grant for the ERP software will be used to offset expenditures on this system in 2019.

REFERENCES:

Ontario. Ministry of Health and Long -Term Care. Financial Planning, Accountability and User Guide for Program -Based Grants for Mandatory and Related Public Health Programs and Services; 2015.